| NPI | 1992767495 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 35.054673) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY 43774) |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2018-05-31 |